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Drug Compliance Undermined By Affordability, Canada

Published
Friday 20 January 2012 Published Fri 20 Jan 2012

By Grace Rattue

According to an investigation by researchers from the University of British Columbia, University of Toronto and the Institute for Clinical Evaluative Sciences published in CMAJ (Canadian Medical Association Journal), the cost of prescription medication affects 1 in 10 Canadians, and 1 in 4 individuals without medication insurance cannot afford to have their prescriptions filled.

The researchers examined data from 5,732 individuals who took part in the Canada Community Health Survey in 2007. The team asked those who received a prescription whether they had difficulties filling a prescription, tried to make the prescription last longer due to the cost, or avoided refilling a prescription. A yes to any of these questions was considered to be cost-related non-adherence to prescription drugs.

Several individuals in Canada do not have insurance for prescription medications and must pay themselves. Despite the country's publicly funded health care for hospital and physician services, universal drug coverage is insufficient. In 2010, individuals in Canada paid a total of $4.6 billion for these expenses, or approximately 17.5% of total spending, on prescription medications.

Results from the investigation reveal that approximately 10% of individuals in Canada who received one or more prescriptions had difficulties filling a prescription due to the cost. British Columbia had the highest rates of cost-related non-adherence at 17%. For individuals on lower incomes, those without medication insurance, or people with poorer health cost-related non-adherence rates were higher.

Dr. Michael Law, Center for Health Services and Policy Research, University of British Columbia, said:

"We found cost-related non-adherence was most commonly reported by individuals who were poor, who reported worse health status, and who had multiple chronic conditions. Among those without drug insurance, cost-related non-adherence was reported by 26.5% compared with only 6.8% among those who reported having drug insurance."

According to statistical projections, cost-related non-adherence is 35.6% more likely for low-income individuals without medication insurance, compared with 3.6% for individuals with insurance on higher incomes.

The researchers conclude: "Reducing cost-related non-adherence would likely improve health and reduce spending in other areas, such as administration to hospital for acute care. Of all the factors we found to be associated with cost-related non-adherence, insurance coverage is the most amenable to being addressed through changes in public policy."

Dr. Law continues:

"We think these findings are timely, with the premiers' Council of the Federation meeting January 16-17, 2012 in Victoria, BC. The country's 13 provincial and territorial premiers should focus on how to address this disparity to improve access to prescription drugs for all Canadians."

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